chapter  23
Pathology of Selected Skin Lesions of the Head and Neck
ByKim M. Hiatt, Shayestah Pashaei, Bruce R. Smoller
Pages 76

Seborrheic keratoses (SKs) are common benign cutaneous neoplasms seen most frequently in adults and the elderly without a gender predilection. With the exception of palms, soles, and mucosal surfaces, SKs may be seen on any site. They present as scaly, greasy, raised growths that range from several millimeters to a centimeter in diameter and are described as having a ‘‘stuck-on’’ appearance, suggesting that they could be simply lifted from the surrounding skin. Many SKs are hyperpigmented, occasionally causing some difficulty in distinction from primary cutaneous melanoma. The variant known as stucco keratosis tends to occur more commonly as verrucous plaques on the extremities. Multiple small SKs may be seen on the face, in particular, the cheeks of dark-skinned patients. This condition, referred to as dermatosis papulosis nigra, is seen twice as frequently in women than in men. Inverted follicular keratosis has been considered a variant of an irritated SK. Recent research shows distinct antigenic expression, which may ultimate in classifying these lesions as distinct entities (1,2).